Filmmaker and content creator Pedro Gabriel Miziara, 27, began going to therapy as a teenager. This lasted almost eight years with the same psychologist, between a few breaks, until the link was abruptly severed with the death of the professional.
“One Monday I rang the office doorbell and he didn’t answer. That only happened once a year. I rang again, he didn’t answer. I found it strange. I went home and sent a message to my girlfriend at the time, joking: ‘I think he’s dead,'” he recalls.
Without news, Miziara learned of the death by accessing the therapist’s personal profile on Facebook, which always appeared as a suggestion. “There was a black and white photo of him and a lot of people were mourning his death. It was a shock,” he says.
Miziara’s story provokes reflection: what are the impacts of losing a professional in whom we place so much trust, such as a therapist? This response is individual, underlines psychologist Celina Daspett, coordinator of Proalu (Bereavement Welcoming Program), at Unifesp (Federal University of São Paulo). However, it is common for the breakup to lead to mourning, particularly in the event of sudden death.
“If the professional is ill, the protocol is different. He can then say goodbye to the patients, direct them to other professionals. A sudden death aggravates the mourning,” explains Daspett.
Two processes increase suffering in situations like Miziara’s. First, the absence of a farewell ritual, such as the wake, which represents the completion of death. “Deaths without a body are more difficult to elaborate. It’s called ambiguous loss: you don’t know if this person is dead or not. Something that happens with political prisoners and missing children,” explains Daspett.
And, secondly, the delegitimization of this sadness by third parties, placing this type of mourning among the unknown – a mechanism similar to what happens after a miscarriage, for example. The main direct effects of this situation are resistance to following therapy and difficulty connecting with a new professional, explains the psychologist.
Miziara says she has experienced both processes. The day after the news, he received a text message from his therapist’s number. It was his son. The two spoke on the phone and cried. “He died the previous Tuesday, a day after seeing me. He had a heart attack during a consultation,” he says.
The psychologist’s son is a psychiatrist and asked him if he needed support or a referral to a new therapist. The filmmaker did not want to start the process again, even though he was going through a vulnerable moment, returning to therapy two years after being released.
“It was years of this therapy. I grew up and my therapist became almost a father figure, who appeared when I needed it, during my puberty, when I was trying to understand the separation of my parents. In the session before his death, he said that he was proud of me”, says the filmmaker.
It wasn’t until the following year, in 2022, that Miziara found himself ready to look for another psychologist. “But I felt like I was cheating on him (the previous one), it was like I was a widower and I was going to use a dating app to find someone,” he says. The sessions did not continue.
In 2023, in the midst of a crisis, he asks for help. Doing online therapy, something new for him, helped. “I think it was important because it was a different environment, not an office. It was at home. I started by saying that I had been in therapy for eight years and my therapist had passed away.”
Bringing this repertoire to sessions is essential. It is the role of the new psychologist to treat the trauma of loss, if that is the patient’s request, advises Daspet. Certain rituals, even simple ones, help give new meaning to grief – like writing a letter or simulating a farewell conversation.
Today, two years after the takeover, Miziara has found a place for every professional. The new therapist is in the present, and the old one resonates through legacy and not through comparisons.
No protocol for psychologists
A study published this year in the United States showed that 80% of psychologists fear that their patients will not be informed of their death. The denial of their own finiteness is one of the main factors that prevent them from creating behaviors adapted to this moment.
“We don’t talk about death. If we think about the social imagination, we live as if we are not going to die, even though we all know that. There is a denial,” says Celina Daspett.
The CFP (Federal Council of Psychology) specifies that there is no protocol on how professionals must prepare for their own death or for situations that prevent them from practicing their profession. The orientation is to ensure the continuity of the link with another therapist and the confidentiality of the patient’s information.
“The link is something very fundamental in psychology. No professional has the obligation to communicate their state of health, regardless of the profession. But it is important to work on the possibility of breaking the link and offering the possibility of looking for another professional”, explains Maria Carolina Roseiro, CFP advisor and doctor from UFES (Federal University of Espírito Santo).
One way to avoid problems is to agree on how patients can access their medical records in extreme cases. “Even if it’s a verbal agreement, indicate how the person can gain access to the records,” says Roseiro. After all, having the medical file allows you to restart the therapeutic process.
Other options are to write a professional will (which contains administrative instructions about practice and instructions to give to patients) or to choose an executor (a professional who will also have a clinical role, providing care and recording medical records).
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